Can I waive my waiting period for health insurance?

Can you get health insurance with no waiting period?

Most health insurance policies have waiting periods—a set period of time you must wait before you can make a claim on your health insurance policy— however, there are a few ways to potentially avoid them.

1. Switch to a similar or lower level policy

If you switch providers, you may be able to skip waiting periods you’ve already served. According to the Private Health Insurance Ombudsman (PHIO), you don’t have to re-serve hospital waiting periods if there’s no break in your coverage. Waiting periods for Extras cover are usually also carried over, but loyalty limits and accrued benefits typically won’t transfer.

2. Review special offers that waive waiting periods

Some providers offer health insurance with no waiting periods to encourage new customer sign-up. These promotions generally only apply to Extras cover for specific treatments. It’s very rare for providers to waive the 12-month waiting periods for major dental treatments like orthodontics or waiting periods for hospital-related services.

Check out Canstar’s list of the latest health insurance sign-up offers available from the providers on our database.

3. Research specific waiting period exemptions

In some cases, you can upgrade your hospital policy to receive higher benefits for psychiatric care while in hospital without a further waiting period. This applies if you’ve already served the two-month waiting period for limited benefits. You can do this at any time, but only once in your lifetime, according to the Australian Government’s Department of Health, Disability and Ageing.

How long are waiting periods?

Waiting periods for hospital treatment can typically range from two to 12 months, depending on the treatment and insurer. For Extras, some providers may have no waiting periods for certain services, while other providers may have waiting periods of up to three years for some treatments.

Bear in mind that waiting periods are just one element to take into account when considering your health insurance options. Other factors such as the level of cover offered by the policy and its cost are also important. You may also still be weighing up the pros and cons of choosing private health insurance entirely.

Waiting periods for hospital cover

The Federal Government sets the maximum waiting periods that insurers can apply for hospital treatment. These are:

• 12 months for pre-existing conditions
  

• 12 months for obstetrics (pregnancy and birth)
  

• Two months for psychiatric care, rehabilitation and palliative care (even for a pre-existing condition)
  

• Two months in all other circumstances.

Waiting periods for Extras cover

The waiting periods for Extras cover are set by individual insurers, rather than the government. This means they can vary from insurer to insurer. To give you an idea of how long you might have to wait, check with a provider directly.

What’s a pre-existing condition and does it affect waiting periods?

A pre-existing condition is generally any illness, ailment or condition that you had signs or symptoms of during the six months prior to you joining a hospital policy or upgrading your cover—even if it hadn’t been officially diagnosed.

Your provider will typically appoint a medical practitioner to assess whether your condition is pre-existing. Fortunately, this doesn’t affect your premiums or how much coverage you’ll be offered by a policy.

Depending on the pre-existing condition, your waiting periods may be extended up to a maximum of 12 months.

Is there any health insurance with no pregnancy waiting period?

Due to the high costs associated with pregnancy and giving birth in the private hospital system, it’s unlikely that you’ll find a provider willing to waive this waiting period. A waiting period of 12 months is usually expected with pregnancy cover, so it’s important to plan ahead if you intend to give birth using private health insurance.

Can I get dental insurance with no waiting period?

Some providers may offer Extras cover with no waiting periods for dental services to new customers. The conditions of these sign-up deals may change between providers, so it’s important to check the terms and conditions of any deal before signing up.

Can I get optical insurance with no waiting period?

Some providers may offer to waive waiting periods for optical cover on certain new policies. Again, the conditions of these deals may change between providers, so be sure to check the terms and conditions before signing up.

Can I still go to the doctor or hospital if my waiting period isn’t up?

If you find yourself needing urgent medical care before your private health insurance policy’s waiting period is up, there may still be options available to you.

Australian citizens, permanent residents and visitors with Overseas Visitors Health Cover (OVHC) and/or from countries with reciprocal healthcare agreements can visit public hospitals and access other urgent medical services for free or with subsidised costs via Medicare.

If you require additional financial support for your healthcare, consider contacting your private health insurer. By providing details of your situation and needs, you can find out if they can provide you with any extra support, even if your waiting period has not yet expired.

Does suspending my health insurance affect my waiting periods?

It’s possible to temporarily suspend your cover for a limited time, such as if you plan to spend time overseas. During this time, your waiting periods are also paused. Once your policy suspension ends and your coverage reactivates, your waiting periods will also resume.